My TRUS/MRI fusion biopsy is now over and the joy of waiting 2-3 weeks for the pathology results begins. The good news is that Dr. Pinto thought it was very unlikely there would be any findings, given all my results so far. In addition, he said they were unable to reproduce the dark (hypoechoic) region that was a concern to Dr. Bard on his ultrasound. He said that one very low risk area they did target may have been in the same general area, but I inferred that there just wasn’t enough information to correlate them from the limited 2D ultrasound images I received from Dr. Bard in New York. From what I’ve gathered, ultrasounds of all types are not always consistent and can even be manipulated to some degree, thus one of the reasons they aren’t widely accepted for prostate cancer detection.
I also got the results of my PSA blood test measured at the NIH. It was 2.7, the same result I had at my urologist in late 2008 and essentially the same result as the first reading of 2.5 I had almost one and a half years ago. This is also a bit of good news, as a rapidly rising PSA level can also be an indicator of prostate cancer. One study of PSA velocity indicated that a change of 0.75 in one year is a concern, while a change of 2.0 in one year suggests a higher risk of aggressive prostate cancer. My level is essentially unchanged or a very slight change, as I understand that day-to-day variations can easily account for a few tenths of a point. So, if my level was to go up to 3.5 or so a year from now, that would probably be a concern, while a smaller increase may be more indicative of prostatitis or BPH.
Anyway, I was discharged from the NIH this morning and am waiting at Reagan National Airport for my flight home. I haven’t had a fever since yesterday morning. I do need to continue my course of prophylactic antibiotics (Cipro) for 2 more days. Otherwise, I’m feeling pretty good. No issues with blood in urine since the first few hours after the procedure. I do have a slight bloody nose this morning, though. I gather it was probably pretty dry in the hospital, especially considering the cold wave that hit while I was there. It was about 15 degrees outside.
My room mate was in fair condition. Recovery from a radical robotic prostatectomy isn’t easy and I’d guess his was pretty typical for the first day. Fortunately, it didn’t sound as if there were any serious complications and I wished him a speedy recovery.
My PSA was 13.7, the first time done although I am 58. The urologist was somewhat alarmed, so when the hospital scheduled me for a month and a half wait for a sonogram, he moved me up to an ER biopsy. This was no fun. No anaesthesia, and an aggressive and leering nurse taking a phone call in the middle of the procedure and insisting on answers while he had the needle in my rectum. He botched one of the two cores he took and took a third. He didn’t use any antiseptic or prep me in any way. It was a nightmare. Now, two days later I feel like I got kicked in the groin by a donkey, and I have been peeing blood every two hours. But, here is the real kicker, the symptoms I had that drove me to the GP resolved with the Cipro. It doesn’t hurt when I pee now. I am hoping that the high PSA was prostatitis, and wishing the urologist had simply put me on a course of the stuff before he went for his needle. The DRE – he said the whole prostate was swollen, left and right. Unnecessary biopsy maybe? Hope so. We will see in a week or so with the pathology report.
I was also told an antibiotic might be something to try before a biopsy if prostatitis is suspected. On the downside, I was told that only a small percentage of prostatitis cases are resolved by antibiotics, as it apparently isn’t always associated with a treatable bacterial infection.